SSB: PERSONAL INFORMATION QUESTIONNAIRE

1.Selection Board (No & Place) Batch No Chest No UPSC Roll No


2. Name in CAPITALS as in application form


3. Father's Name


4. (a) Place of maximum residence
(b) Present Address (With Approximate
population of the City/town/village)
(c) Permanent Address (With Approximate
population of the City/town/village)
(Whether District HQ or Not)


5.Fill in the details below:


6.(a) Parents Alive Yes/NoState & District Religion WhetherSC/ST Mother Tongue Date of Birth
Married/Single/Widowed
(b) If not alive your age at the time of Father's/Mother's Death
(c) Parents/Guardians Occupation /Income (As applicable)
Particulars Education Occupation Income per Month
Father
Mother
Guardian
No of brothers
No of sisters
Your ranking amongst your brother and sister

7. Educational Record(Commencing from matriculation /Equivalent Examination):-
S.No QualificationAcquired Name of Institute Year Division&Marks% Medium ofInstruction
Boarder/DayScholar Out Standing Achievement if any
a) Matric/Higher Secondary
b) 10+2
c) B.A/B.Sc/B.Com
d) Professional

8. Age ( Year & Months) / Height (in Metre) Weight (in Kilograms)
10
(a) N.C.C Training _________________________________________ Yes/No
(b) Total Training (if Yes) (Give details below)
Total Training Wing Division Certificate Obtained

11. a) Participation in Games & Sports
Games/Sports Period or Duration of Participation Represented School/College/University
OutstandingAchievement, if any
b)Hobbies/Interest
c) Participation in Extra curricular activities :-
Name of the activity group Duration of Participation Outstanding achievement if any
d) Position of responsibility/Offices held in NCC/Scouting
Sports team/Extra-curricular group and other fields:-

12.(a) Nature of Commission
(b) Choice of Service

13. Number if chances availed for commission in all three services

14. Details of last interview ,if any (Air Force/Navy/Army Selection Board)
S.No Type of Entry Place and SSB No Date Batch and Chest Number Recommended/Not Recommended